10 Things Your Adoption Agency Won't Tell You

Adopting a child can be time-consuming, expensive and risky. It doesn't have to be.

1. "Want to adopt? You're on your own." Adoption may seem an altruistic endeavor, but it's also a big business -- and a loosely regulated one. "Nobody's watching for cheaters," says Adam Pertman, executive director of the Evan B. Donaldson Adoption Institute and author of Adoption Nation.

Adoption has always been a local, not federal, issue, and statutes governing it vary from state to state. Few states, Pertman says, go far enough in monitoring and enforcing standards that would prevent adoption agencies from pressuring pregnant women and lying to adoptive parents. So buyer beware.

How can you start the process with confidence? Avoid searching the Web blindly; the Internet is replete with agencies that lack a physical location -- a major red flag. Instead, check out the National Adoption Directory, a database funded by the Department of Health and Human Services that lists licensed agencies by state. You can research an agency's history of complaints by contacting the licensing specialist -- also listed on the site -- in the state where your adoption will take place. Finally, the directory can point you to support groups that offer independent references for an agency.

2. "We have no idea how long this will take." When prospective parents ask how long an adoption will take, agencies often quote an average of one to two years. But the process can take months longer.

First, a social worker conducts a home study to gauge your ability to become an adoptive parent. It includes essays, counseling, home visits and FBI clearance. Agencies typically don't include time for the home study in their estimates, so be sure to factor in the four months it often takes.

Next, you must wait for a child or birth mother to be identified, then go through the legal steps -- mostly paperwork -- to finalize the adoption. International adoptions, in which the children often come from orphanages, can get slowed down by the country of origin's political problems or red tape. In domestic infant adoptions, the adoption agency compiles a profile describing each family and the environment it can provide a child. The birth mother picks the adoptive parent based on these profiles, and she can be swayed by a seemingly unimportant detail, such as prospective parents' native state or a pet's name. To avoid disappointment during your adoption, ask what the average wait time is for people who have yet to be picked by a birth mother.

3. "Speed now can mean heartache later." Although domestic adoptions are very rarely contested in court, experts estimate that about half of birth moms decide to keep the child at some point between the initial verbal commitment to adoption and the official termination of legal rights after the birth.

If an agency promises brisker-than-average results, take it as a warning that it may not be adequately investigating who else in the birth mother's family is involved. Ask if the agency has ruled out the possibility of any biological relatives trying to claim the child. Maureen Flatley Hogan, a Boston-based adoption lobbyist, notes recent cases in which the child's paternal grandparents challenged an adoption. You'll also want to ask what steps were taken to include the father in the process. Beware if the agency tells you the birth mom doesn't know who the father is. It could leave the door open for a potential father to make a claim later.

Sometimes a birth mother contacts an agency within days of her delivery. In those cases, relinquishment shouldn't happen until she's out of the hospital and has received eight to 12 hours of counseling with a social worker from an agency with extensive adoption experience. Otherwise she may regret her decision.

4. "You make a lot of money? Oops, our fee just went up." Using an agency for an adoption usually costs between $15,000 and $30,000, according to Pertman. Your out-of-pocket costs can include a home study, the process of identifying a child, placement fees and postplacement visits by a social worker. For international adoptions, they may also include the cost of visas, document translation and a contribution to the orphanage. The precise fee you'll pay for each service varies from one agency to the next. To comparison-shop, ask agencies for an itemized list of charges, and consider dropping any firm that won't cooperate.

Be wary of any agency that asks for your financial information before providing an itemized list of charges. A home study, required for all adoptions, usually runs between $1,000 and $3,000, but lobbyist Hogan recently came across an agency that was charging consumers 10 percent of their annual income. Other agencies have inflated charges when consumers are eligible for the adoption tax credit. If your 2003 income is below $192,390, you can claim all or a portion of the $10,130 credit. "If the agency knows a family will be eligible, they may increase the cost of the adoption because, after all, the family will get it back in their taxes," Hogan says.

5. "Our quoted fee is only a fraction of what you'll spend." Besides checking the breakdown of an agency's fees, you'll need to ask about extra costs that often aren't listed at all. In an international adoption, many parents find that once they arrive in the particular country, they are asked to pay bribes to grease the wheels with government officials. For domestic infant adoptions, agencies may not tell you about your responsibility for the birth mother's living and medical expenses, which can run several thousand dollars, until later in the game. "It is especially disturbing when a mom's fees are charged 'retroactively' for periods of time when the couple didn't even know she existed," Hogan says.

If you're paying a birth mother's living expenses, ask to write the check directly to the provider, such as the birth mother's electric company, instead of having the agency give her your money. You'll also want to see proof of the birth mother's medical expenses; to preserve her privacy, the agency should be able to delete the birth mother's identifying information. According to Pertman, some agencies have charged adoptive parents for the full price of health care even though the birth mother was already covered through Medicaid or a state-subsidized program.

6. "We'll apply more pressure than a car salesman." Preadoptive parents are understandably hesitant to question the kinds of activities that would in other circumstances send them running. Every adoption agency understands this insecurity; the worst firms exploit it with pressure tactics more commonly seen in an automobile dealership. There's even the adoption world's version of the bait and switch -- you arrive in a foreign country to find a child who is much older than the one you thought you were adopting or has serious medical problems.

Another tactic in international adoptions: ratcheting up the pressure after the parents have received the medical history and a photo of the child and must decide if they want to adopt him. Some agencies will call the couple on a Friday and give them the weekend to decide. Or they're told that other families or agencies are considering the child, and whoever decides first gets him.

Of course, it would be irresponsible to allow a child to languish in an orphanage while a couple takes six months to decide. The best agencies balance these factors by giving the prospective parents about a week to turn down the referral or to make a tentative verbal commitment with the caveat that they can ask for additional information.

7. "The people we work with overseas are unreliable." When evaluating a U.S. agency that does international adoptions, ask about the people the agency works with overseas. Often called "agents" or "facilitators," they act as liaisons between the agency and the orphanages.

Many agencies have every intention of working with reputable facilitators, but in too many cases, the go-betweens have sketchy qualifications, as a Michigan family learned after adopting a child from Russia. In the course of a wrongful-adoption suit alleging that the agency failed to disclose the child's multiple congenital anomalies, the parents discovered that the facilitator had no social-work training; he was a furniture refinisher and didn't even speak Russian.

Before committing to an agency, ask about its overseas liaisons. Are they trained child-welfare professionals? To what degree does the agency assume responsibility for the acts of employees and facilitators abroad? How are facilitators paid? Some receive salaries, which is a good sign, while others are paid for each successful find, which encourages unethical players who just want fast cash. Finally, ask your agency if it's insured; if it isn't, you'll have little recourse in a potential lawsuit.

8. "Children adopted overseas have serious health risks." Many agencies would have you believe that children adopted overseas are healthy kids in need of nothing more than love. But many of these children arrive in the U.S. with problems that are as great as or greater than those faced by children in domestic foster care.

Many children adopted overseas have spent time in institutions. As a result, there is a possibility of medical and developmental issues that should be explored before you bring a child home. For example, fetal alcohol syndrome is common among children adopted from Eastern Europe. Research has also shown that some institutionalized children have difficulty forming close relationships.

The good news is that even the most severe problems can be tackled with early intervention. Some of the best agencies offer classes that cover these issues, but to learn more on your own, check out www.adoptionlearningpartners.org, which offers a comprehensive online education program entitled With Eyes Wide Open: A Preparation Guide to International Adoption for $25. Also, the list of adoption experts at www. adoptionresearch.org/research.html includes relevant articles and studies.

9. "Our medical information is incomplete." Once you know the potential for health problems, you'll face another hurdle: getting specific medical information about your prospective child overseas. Record keeping in the birth country might have been slipshod, or the child may have been abandoned. Even in such cases, however, some helpful information is usually available -- if your agency bothers to get it. According to a survey conducted by the Adoption Institute, 15 percent of the 1,600 responding families adopting overseas reported that their agency withheld details or gave them inaccurate information about the child.

At a minimum, the agency should have material on what the child looked like the day he was brought in -- how much he weighed, whether he was responsive -- and his current physical and mental health. Typically, the agency will give you a photo or videotape of the child and will hire a translator to provide a summary of his medical report. As soon as you receive the information, ask a pediatrician who specializes in international adoptees to review it. Find one on the directory at the American Academy of Pediatrics' Web site.

You should also request the original documentation so your pediatrician can compare it with the translation, checking for missing pages. Ann Arbor, Mich., pediatrician Jerri Jenista once saw two different medical reports from two different agencies about the same child. One agency failed to translate a critical sentence: "The mother was an alcoholic and murdered the child's sibling."

10. "You got your child . . . See ya!" The best adoption agencies offer postadoption services that guide parents through a range of problems, from explaining adoption to the child to dealing with their own "postadoption depression," surprisingly common among these parents.

If a child develops a medical condition, parents should be able to call the agency to ask whether it runs in the birth parents' families. One top adoption agency even arranges to have social workers meet with the child's teachers to help them understand any problems. And many parents return to their agency when the child is old enough to consider getting in touch with the birth mother. Many agencies, however, end their services the day you bring your child home.

To evaluate the level of service, ask the agency to give you names and phone numbers of three clients whose adoptions were completed at least three years ago. Ask those adoptive parents how the agency handled both postadoption services and the adoption process itself.